钛板与弹性髓内钉修复锁骨中段骨折的Meta分析  

Meta-analysis of titanium plate and elastic intramedullary nail in the treatment of midshaft clavicular fractures

作　　者：叶勇[1] 李军[1] 荆珏华[1] 

机构地区：[1]安徽医科大学第二附属医院骨科,安徽省合肥市230601

出　　处：《中国组织工程研究》2016年第26期3938-3945,共8页Chinese Journal of Tissue Engineering Research

基　　金：安徽医科大学校基金(2013xkj032);安徽省自然科学基金(1308085MH156)~~

摘　　要：背景:锁骨中段骨折的手术治疗方法主要有钛板固定和弹性髓内钉固定2种,但二者的对比研究较少,且大多数为回顾性病例分析。目的:比较钛板与弹性髓内钉2种固定方式对于锁骨中段骨折的疗效。方法:检索Pub Med、CBM、Embase、Cochrane Library、CNKI和万方数据库,文献发表时间截止至2015年9月,搜索与锁骨中段骨折治疗相关的资料,并对其进行文献质量评估。结果与结论:1纳入7篇文献,共512例患者;2Meta分析表明,弹性髓内钉组肩关节恢复情况优于钛板组(P<0.01);3弹性髓内钉组在骨折平均愈合时间、手术时间、切口长度、术中出血量及住院时间等方面均小于或少于钛板固定组(P<0.01);4两组在并发症方面差异无显著性意义;5由此可见,弹性髓内钉固定治疗锁骨中段骨折的疗效优于钛板固定,可作为锁骨中段骨折的首选治疗方式,但该结论还需要大规模、多中心的随机对照试验来进一步验证。BACKGROUND：Elastic stable intramedullary nailing and titanium plate fixation are two methods for the treatment of midshaft clavicular fractures.Current research about comparison of these two methods is not too much,and most of cases were retrospectively analyzed.OBJECTIVE：To compare the efficacy of elastic stable intramedullary nailing and titanium plate fixation for midshaft clavicular fractures.METHODS：The Pub Med database,CBM,EMbase database,Cochrane Library database,CNKI database and Wangfang database were searched to collect the trials on midshaft clavicular fractures.The searching time ranged from the date of building to September 2015.The quality of trails was evaluated.RESULTS AND CONCLUSION：（1） Seven trials involving 512 patients were included.（2） Meta-analysis results showed the postoperative functional recovery was better in the elastic stable intramedullary nailing group than that of the plate fixation group（P〈 0.01）.（3） The average bone union time,operation time,incision length,intraoperative blood loss and the hospital stay of the elastic stable intramedullary nailing group were less than those of the plate fixation group（P〈 0.01）.（4） There were no significant differences in incidence rate of complications between two groups.（5） It is concluded that elastic stable intramedullary nailing for treating midshaft clavicular fractures is superior to the plate fixation in the efficacy.As the first choice for treatment of midshaft clavicular fractures,above conclusions are needed to be verified by large-scale multi-center randomized controlled trials.

关 键 词：锁骨 骨折 META分析 内固定器 组织工程 骨科植入物 骨植入物 钛板 髓内钉 并发症 安徽省自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]